What is the truth about President Obama’s plan for health care reform? Even after his speech to a joint session of Congress, questions still remain.

It is easy to speak banalities about affordable coverage for all, “security and stability,” etc., but, as the saying goes, the devil is in the details.

The President claims his plan will cost “around” $900 billion dollars over the next ten years and will not add “one dime to our deficits -- either now or in the future.” A nice sound bite to be sure, but is it true?

The President said this will be made possible by reducing the “wastes and inefficiencies” in Medicaid and Medicare. So the President is going to pay for one multi-billion dollar health care program by eliminating “wastes and inefficiencies” in the existing multi-billion dollar health care program? Wouldn’t it be easier to improve and repair the current bureaucratic monstrosity rather than create a brand new one?

Pretending for the moment that the President is being truthful when he claims his plan will be deficit-neutral, is he being truthful about other aspects of “The Obama Plan: Security and Stability for All Americans?” The President promised to protect Medicare for seniors. An impressive claim considering he is planning to siphon off $900 billion from Medicare and Medicaid to pay for his health care reform package.

The Obama plan further proposes to make it illegal to deny coverage for anyone with a pre-existing condition and to eliminate higher premiums based on age and gender. That may be true, but it is not the whole truth. It follows logically that his plan will thereby raise premiums for those who are young, in good health and have no preexisting conditions.

The President also continues to advocate a “self-sufficient” public option that will “promote competition.” Again, nice sound bite, but how exactly does an organization with the purchasing power of the federal government promote competition? Undercut competition, yes. Promote competition, not so much.

Then there is the problem of coverage for all. In his speech, the President said his plan, “will provide more security and stability to those who have health insurance. It will provide insurance for those who don't.”

There are an estimated 47 million people in this country without health insurance. The Pew Hispanic Center claims seven million of those are in the country illegally. Other estimates are considerably higher – as many as 22 million. The President said his reforms would not apply to those in the country illegally.

Rep. Joe Wilson (R-SC), a voice for millions of conservatives nationwide, took issue with that statement shouting out “You lie!” in a nationally televised moment that has been seized upon by liberals as demonstrative of the irrationality of Republicans everywhere.

So what exactly is the truth about that aspect of the President’s plan? If you visit the White House web site and read “The Obama Plan: Security and Stability for All Americans,” you will find no mention of illegal immigrants. What you have by way of assurances on the matter is the President’s word and what has been documented in the health care reform proposals to date. Not surprisingly, the two are somewhat at odds.

The Congressional Research Service (CRS), a non-partisan organization, analyzed H.R. 3200 to determine what, if any, impact it would have on non-citizens. The CRS determined that the proposed legislation had no restrictions prohibiting non-citizens from participating in the health insurance exchange and no mechanism for verifying immigration status. They also determined that in certain circumstances non-immigrants would be eligible for premium credits. Unauthorized aliens would not receive credit, but, under IRS rules, they might actually be required to purchase insurance if they have been in the country long enough to meet the substantial presence test.

In other words, the President’s reforms will not apply to illegal immigrants unless of course they have been in the United States for at least 31 days during the current calendar year and at least 183 days during the previous two years. Those unauthorized aliens would have to purchase insurance by law but, according to the President, would also be prohibited by law from doing so.

Furthermore, we already pay for medical services for illegal immigrants through emergency Medicaid. Nothing in the current proposed legislation is going to change that. We are a compassionate people and are not likely to deny a person in need of medical services treatment regardless of their immigration status. For the President and the Democrats to refuse to acknowledge that reality is dissembling at best.

The President’s plan may not have any provisions that provide coverage for illegal immigrants outright, but it does not appear to have any provisions specifically prohibiting coverage either.

Rep. Wilson may have been out of order when he said the President lied, but he may be dead right about the President’s veracity.

The truth about health care reform is that no one knows exactly what is going to be in the plan, no one fully understands the five separate bills that have already been proposed and no one has any idea how we are going to pay for it in the long run. Anyone who says otherwise is lying.

The first steps should be to allow all 1300 health care insurance providers the ability to compete in every state.

Next, we must treat illegals in the ERs of our hospitals; it is the right thing to do. Then after treatment, they should be deported. After a few thousand of those cases, the illegals would stop going to the ER for colds, thereby reducing the costs.

Tort reform. Place caps on the dollar amounts that can be awarded - do not allow frivolous suits.

For those who still cannot afford insurance - and are legal, productive members of society, add them to the Medicare system until they can afford insurance on their own.

Tort reform is iffy. If you cap damages, you risk hurting people with genuine lawsuits for amounts higher than the amount of the cap.

Letting insurance companies go across state lines will cause what happened in the credit card industry where the companies relocate to states with laws that are the most friendly toward their business.

And on the last one, where's the cutoff on "productive member"? Many people who lose (or don't have) insurance are in that position because they lost their job or got injured and couldn't work.

The latter group often has an injury that needs to be treated before they can go back to work, but they can't afford the treatment for lack of insurance.

The former group becomes uninsurable if they get hurt while looking for a job or waiting for insurance in a new job to become available.

These are good ideas on the surface, but the potential consequences can't be ignored. If you have some way to mitigate these issues, that would be great.

Tort reform is iffy. If you cap damages, you risk hurting people with genuine lawsuits for amounts higher than the amount of the cap. - This is true – there is a potential for a few to be “under compensated”, but as it stands today most are over compensated creating additional costs that are picked up by the consumers (those paying insurance premiums). I lived in Japan for years – their tort system uses calculations based on potential earnings, for example: let’s say you’re responsible for the death of a 50 year old male who makes $50,000 per year. He could have worked an additional 15 years. $50K x 15 years = $750,000 award. This is a guide – and could have additional flexibility added for special circumstances. I’m also not saying this is an example – but a way for us to start thinking out of the box

Letting insurance companies go across state lines will cause what happened in the credit card industry where the companies relocate to states with laws that are the most friendly toward their business. – Credit card companies don’t compete, they prey. Allowing insurance companies to compete for health insurance dollars would have to drive the costs down. Health insurance and credit cards are apples and oranges.

And on the last one, where's the cutoff on "productive member"? Many people who lose (or don't have) insurance are in that position because they lost their job or got injured and couldn't work. – In my opinion, a productive member is a non-felon or a felon with a 10 year clean track record who is willing to work. Let’s say this person cannot find a job, and the government is required to cover health care costs. A productive member of society would be willing to work to pay the bill. Let’s say his “premium” the government would cover is $800 per month. A productive member of society, willing to work, would be willing to put in 80 hours a month somewhere to cover the bill. That would give them 80 working hours per month to find a job.

The latter group often has an injury that needs to be treated before they can go back to work, but they can't afford the treatment for lack of insurance. - If they are unable to go back to work, then they are on disability and should be entitled to use the Medicare system.

The former group becomes uninsurable if they get hurt while looking for a job or waiting for insurance in a new job to become available. – again a situation for Medicare

This is so laden with misunderstanding that I can't go point-by-point, but I will cover some general things.

Cost go down by adding more low risk people to the risk pool: http://en.wikipedia.org/wiki/Risk_pool. A lot of the tens of millions of uninsured people fit into this category. At worst it'll be a net neutral financially with tens of millions of people protected from financial ruin.

The Medicare programs that are being killed aren't doing what they were supposed to do. Obama wants to take those pieces out and replace them with ideas proposed by actual practicing doctors, not the lobbyist written things in there now. At the moment they're little more than a handout to the insurance companies. The insurance companies do nothing to improve care with the tax dollars we're giving to them.

And I couldn't bear to read the whole thing, but I'm assuming you mentioned the price tag of 900 billion over 10 years. Let's do the math on that.

I'll be honest, 7.5b a month seems like a small price to pay to ensure 30-45 millions--and growing--of my neighbors aren't ruined (and effectively removed from the economy) by something beyond their control. With how the government often spends our money (like those medicare bits mentioned earlier), this is wonderful.

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